Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

IV PUSH EA ADDL DRUG SAME

Facility

$339.24

Service Code	HCPCS 96376
Hospital Charge Code	270339106
Hospital Revenue Code	260
Min. Negotiated Rate	$50.89
Max. Negotiated Rate	$50.89
Rate for Payer: Qualcare PPO/HMO/WC	$50.89

IV PUSH EA ADDL DRUG SAME

Facility

$339.24

Service Code	HCPCS 96376
Hospital Charge Code	5100781
Hospital Revenue Code	260
Min. Negotiated Rate	$50.89
Max. Negotiated Rate	$50.89
Rate for Payer: Qualcare PPO/HMO/WC	$50.89

IV PUSH EA ADDL DRUG SAME

Facility

$339.24

Service Code	HCPCS 96376
Hospital Charge Code	2011451
Hospital Revenue Code	260
Min. Negotiated Rate	$50.89
Max. Negotiated Rate	$50.89
Rate for Payer: Qualcare PPO/HMO/WC	$50.89

IV PUSH EA ADDL DRUG SAME

Facility

$339.24

Service Code	HCPCS 96376
Hospital Charge Code	2250413
Hospital Revenue Code	260
Min. Negotiated Rate	$50.89
Max. Negotiated Rate	$50.89
Rate for Payer: Qualcare PPO/HMO/WC	$50.89

IV PUSH EA ADDL DRUG SAME

Facility

$339.24

Service Code	HCPCS 96376
Hospital Charge Code	73190113
Hospital Revenue Code	260
Min. Negotiated Rate	$8.84
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$128.91
Rate for Payer: Aetna Medicare Advantage	$101.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.51
Rate for Payer: Cigna Commercial	$169.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.20
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.89
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$10.72
Rate for Payer: Wellpoint Medicaid Managed Care	$9.63

IV PUSH EA ADDL DRUG SAME

Facility

$339.24

Service Code	HCPCS 96376
Hospital Charge Code	8200514
Hospital Revenue Code	260
Min. Negotiated Rate	$8.84
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$128.91
Rate for Payer: Aetna Medicare Advantage	$101.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.51
Rate for Payer: Cigna Commercial	$169.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.20
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.89
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$10.72
Rate for Payer: Wellpoint Medicaid Managed Care	$9.63

IV PUSH EA ADDL DRUG SAME

Facility

$339.24

Service Code	HCPCS 96376
Hospital Charge Code	4501034
Hospital Revenue Code	260
Min. Negotiated Rate	$8.84
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$128.91
Rate for Payer: Aetna Medicare Advantage	$101.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.51
Rate for Payer: Cigna Commercial	$169.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.20
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.89
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$10.72
Rate for Payer: Wellpoint Medicaid Managed Care	$9.63

IV PUSH EA ADDL DRUG SAME

Facility

$339.24

Service Code	HCPCS 96376
Hospital Charge Code	73237027
Hospital Revenue Code	260
Min. Negotiated Rate	$50.89
Max. Negotiated Rate	$50.89
Rate for Payer: Qualcare PPO/HMO/WC	$50.89

IV PUSH EA ADDL DRUG SAME

Facility

$339.24

Service Code	HCPCS 96376
Hospital Charge Code	8200514
Hospital Revenue Code	260
Min. Negotiated Rate	$50.89
Max. Negotiated Rate	$50.89
Rate for Payer: Qualcare PPO/HMO/WC	$50.89

IV PUSH EA ADDL DRUG SAME

Facility

$339.24

Service Code	HCPCS 96376
Hospital Charge Code	5700258
Hospital Revenue Code	260
Min. Negotiated Rate	$8.84
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$128.91
Rate for Payer: Aetna Medicare Advantage	$101.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.51
Rate for Payer: Cigna Commercial	$169.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.20
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.89
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$10.72
Rate for Payer: Wellpoint Medicaid Managed Care	$9.63

IV PUSH EA ADDL DRUG SAME

Facility

$339.24

Service Code	HCPCS 96376
Hospital Charge Code	5100781
Hospital Revenue Code	260
Min. Negotiated Rate	$8.84
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$128.91
Rate for Payer: Aetna Medicare Advantage	$101.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.51
Rate for Payer: Cigna Commercial	$169.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.20
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.89
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$10.72
Rate for Payer: Wellpoint Medicaid Managed Care	$9.63

IV PUSH FIRST DRUG

Facility

$2,800.00

Service Code	HCPCS 96374
Hospital Charge Code	93500061
Hospital Revenue Code	260
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

IV PUSH FIRST DRUG

Facility

$339.24

Service Code	HCPCS 96374
Hospital Charge Code	73237025
Hospital Revenue Code	260
Min. Negotiated Rate	$9.63
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$687.34
Rate for Payer: Aetna Medicare Advantage	$818.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$916.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$916.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$252.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$916.67
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: Cigna Medicare Advantage	$252.70
Rate for Payer: Clover Medicare Advantage	$240.06
Rate for Payer: EmblemHealth Commercial	$758.10
Rate for Payer: Humana Medicare Advantage	$260.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$252.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.20
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.89
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$10.72
Rate for Payer: UnitedHealthcare Medicare Advantage	$252.70
Rate for Payer: Wellcare Medicare Advantage	$252.70
Rate for Payer: Wellpoint Medicaid Managed Care	$9.63

IV PUSH FIRST DRUG

Facility

$2,800.00

Service Code	HCPCS 96374
Hospital Charge Code	270339101
Hospital Revenue Code	260
Min. Negotiated Rate	$34.92
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$687.34
Rate for Payer: Aetna Medicare Advantage	$818.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$916.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$916.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$252.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$916.67
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: Cigna Medicare Advantage	$252.70
Rate for Payer: Clover Medicare Advantage	$240.06
Rate for Payer: EmblemHealth Commercial	$758.10
Rate for Payer: Humana Medicare Advantage	$260.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$252.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$728.00
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$88.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$252.70
Rate for Payer: Wellcare Medicare Advantage	$252.70
Rate for Payer: Wellpoint Medicaid Managed Care	$79.52

IV PUSH FIRST DRUG

Facility

$394.88

Service Code	HCPCS 96374
Hospital Charge Code	93500065
Hospital Revenue Code	260
Min. Negotiated Rate	$59.23
Max. Negotiated Rate	$59.23
Rate for Payer: Qualcare PPO/HMO/WC	$59.23

IV PUSH FIRST DRUG

Facility

$2,800.00

Service Code	HCPCS 96374
Hospital Charge Code	8200512
Hospital Revenue Code	260
Min. Negotiated Rate	$34.92
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$687.34
Rate for Payer: Aetna Medicare Advantage	$818.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$916.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$916.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$252.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$916.67
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: Cigna Medicare Advantage	$252.70
Rate for Payer: Clover Medicare Advantage	$240.06
Rate for Payer: EmblemHealth Commercial	$758.10
Rate for Payer: Humana Medicare Advantage	$260.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$252.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$728.00
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$88.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$252.70
Rate for Payer: Wellcare Medicare Advantage	$252.70
Rate for Payer: Wellpoint Medicaid Managed Care	$79.52

IV PUSH FIRST DRUG

Facility

$2,800.00

Service Code	HCPCS 96374
Hospital Charge Code	1600515
Hospital Revenue Code	260
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

IV PUSH FIRST DRUG

Facility

$2,800.00

Service Code	HCPCS 96374
Hospital Charge Code	270339101
Hospital Revenue Code	260
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

IV PUSH FIRST DRUG

Facility

$339.24

Service Code	HCPCS 96374
Hospital Charge Code	74117057
Hospital Revenue Code	260
Min. Negotiated Rate	$50.89
Max. Negotiated Rate	$50.89
Rate for Payer: Qualcare PPO/HMO/WC	$50.89

IV PUSH FIRST DRUG

Facility

$1,080.95

Service Code	HCPCS 96374
Hospital Charge Code	5790895
Hospital Revenue Code	450
Min. Negotiated Rate	$30.70
Max. Negotiated Rate	$916.67
Rate for Payer: Aetna Commercial	$687.34
Rate for Payer: Aetna Medicare Advantage	$818.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$916.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$916.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$252.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$916.67
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: Cigna Medicare Advantage	$252.70
Rate for Payer: Clover Medicare Advantage	$240.06
Rate for Payer: EmblemHealth Commercial	$758.10
Rate for Payer: Humana Medicare Advantage	$260.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$252.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$281.05
Rate for Payer: Qualcare PPO/HMO/WC	$162.14
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$252.70
Rate for Payer: Wellcare Medicare Advantage	$252.70
Rate for Payer: Wellpoint Medicaid Managed Care	$30.70

IV PUSH FIRST DRUG

Facility

$2,800.00

Service Code	HCPCS 96374
Hospital Charge Code	5300145
Hospital Revenue Code	260
Min. Negotiated Rate	$34.92
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$687.34
Rate for Payer: Aetna Medicare Advantage	$818.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$916.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$916.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$252.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$916.67
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: Cigna Medicare Advantage	$252.70
Rate for Payer: Clover Medicare Advantage	$240.06
Rate for Payer: EmblemHealth Commercial	$758.10
Rate for Payer: Humana Medicare Advantage	$260.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$252.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$728.00
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$88.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$252.70
Rate for Payer: Wellcare Medicare Advantage	$252.70
Rate for Payer: Wellpoint Medicaid Managed Care	$79.52

IV PUSH FIRST DRUG

Facility

$2,800.00

Service Code	HCPCS 96374
Hospital Charge Code	5100779
Hospital Revenue Code	260
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

IV PUSH FIRST DRUG

Facility

$1,076.70

Service Code	HCPCS 96374
Hospital Charge Code	395096374
Hospital Revenue Code	260
Min. Negotiated Rate	$30.58
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$687.34
Rate for Payer: Aetna Medicare Advantage	$818.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$916.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$916.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$252.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$916.67
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: Cigna Medicare Advantage	$252.70
Rate for Payer: Clover Medicare Advantage	$240.06
Rate for Payer: EmblemHealth Commercial	$758.10
Rate for Payer: Humana Medicare Advantage	$260.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$252.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$279.94
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$161.50
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$34.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$252.70
Rate for Payer: Wellcare Medicare Advantage	$252.70
Rate for Payer: Wellpoint Medicaid Managed Care	$30.58

IV PUSH FIRST DRUG

Facility

$1,076.70

Service Code	HCPCS 96374
Hospital Charge Code	395096374
Hospital Revenue Code	260
Min. Negotiated Rate	$161.50
Max. Negotiated Rate	$161.50
Rate for Payer: Qualcare PPO/HMO/WC	$161.50

IV PUSH FIRST DRUG

Facility

$339.24

Service Code	HCPCS 96374
Hospital Charge Code	5700256
Hospital Revenue Code	260
Min. Negotiated Rate	$9.63
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$687.34
Rate for Payer: Aetna Medicare Advantage	$818.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$916.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$916.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$252.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$916.67
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: Cigna Medicare Advantage	$252.70
Rate for Payer: Clover Medicare Advantage	$240.06
Rate for Payer: EmblemHealth Commercial	$758.10
Rate for Payer: Humana Medicare Advantage	$260.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$252.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.20
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.89
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$10.72
Rate for Payer: UnitedHealthcare Medicare Advantage	$252.70
Rate for Payer: Wellcare Medicare Advantage	$252.70
Rate for Payer: Wellpoint Medicaid Managed Care	$9.63

Know your out-of-pocket cost for care.

All Charges